MAINE-DARTMOUTH FAMILY MEDICINE RESIDENCY ADVANCEMENT COMMITTEE RESIDENT EVALUATION REVIEW FORM
Resident: Advisor: Last evaluation date: Evaluation date: Advisor Meeting: Advisor Meeting: Committee member presenting: COMMENTS ON INDIVIDUALIZED LEARNING PLAN: CURRICULUM REQUIREMENTS: ¶Longitudinal curriculum (Nursing home visits)?y/n ¶Required supplemental study completed?y/n COMPETENCIES: I. PATIENT CARE 1 – Rotation Evaluations 2. Chart Audits HPI
3. Patient volume 4. Procedure logs II. MEDICAL KNOWLEDGE III. PRACTICE BASED LEARNING Resident evaluations – Conference attendance – IV. INTERPERSONAL AND COMMUNICATION SKILLS V. PROFESSIONALISM Face-to-Face meeting with Advisor –
Targets for the next evaluation include: ¶ COMMENTS:
ADVANCEMENT COMMITTEE
RESIDENT EVALUATION REVIEW FORM
Resident:
Advisor:
Last evaluation date:
Evaluation date:
Advisor Meeting:
Advisor Meeting:
Committee member presenting:
COMMENTS ON INDIVIDUALIZED LEARNING PLAN:
CURRICULUM REQUIREMENTS:
¶ Longitudinal curriculum (Nursing home visits)? y/n
¶ Required supplemental study completed? y/n
COMPETENCIES:
I. PATIENT CARE
1 – Rotation Evaluations
2. Chart Audits
HPI
3. Patient volume
4. Procedure logs
II. MEDICAL KNOWLEDGE
III. PRACTICE BASED LEARNING
Resident evaluations –
Conference attendance –
IV. INTERPERSONAL AND COMMUNICATION SKILLS
V. PROFESSIONALISM
Face-to-Face meeting with Advisor –
Targets for the next evaluation include:
¶
COMMENTS: